1) Impact of including accrued interest income in MAGI for Medicare premium determination
While accrued interest for a regular bond may be deducted from earned interest for tax purposes, my question has to do with the same for muni bonds. Muni bond interest is exempt from income taxes, but Medicare premiums are determined based on MAGI which includes tax exempt muni bond interest income. Can this ‘unearned’ accrued interest income be netted out when calculating MAGI?

2) Impact of accrued interest on withdrawals from IRA accounts
There is no tax implication for earnings in IRA accounts until one makes a withdrawal, such as for RMDs. Then it becomes patently unfair to be taxed for a bond’s accrued interest as part of the withdrawal amount. Is there a way to deduct the accrued interest from the withdrawl amount to calculate taxes owed?